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皮肤科和美学市场:新常态下的保留价值

了解新的趋势有助于加强皮肤科和美容市场，并为未来的实践决策。

克林特·邦迪

由于大流行，过去18个月内的新相关因素已经确定了皮肤病学和美学市场。这包括临时实践停工，重新开放和皮肤病的重新训练，以及采用替代实践方法和解决方案。无论挑战和变化如何，消费者都继续重视皮肤科和美学提供者必须提供什么。这些行业的实力和吸引力是通过这些医疗细分市场的强劲的兼并和收购和资本安置活动证明。了解新趋势有助于加强皮肤病学和美学市场，以及未来的塑造实践决策。大流行：调整和解决方案Covid-19在2020年初春的北美侵犯了大多数行业的初期，皮肤科和审美市场也不例外。国际皮肤病社会完成了对大流行影响的678名皮肤科医生的调查，334名受访者中所说的Covid-19在Pandemy.1 Dan Rodgers，皮肤和审美总裁中的日常工作活动中造成了超过75％的人中心，中西部，多地点皮肤科小组，评论，“为了在大流行中生存，我认为每个行业都受到挑战，以磨练效率，并重新发明它们对市场的方法。非常少数人被视为审美空间，因为强制性停止在选修程序中强迫化妆品的重型实践，迅速枢转以保持最小的现金流量。“为了打击挑战，皮肤病学和美学群体必须采用创造性手段来服务患者和驱动性能。 Figure 1: NEXTPatient: Average Monthly Appointments Booked Online The use of new technologies and services demonstrated providers could embrace the adage of “necessity is the mother of invention.” Mr. Rodgers further comments, “Ambitious plastic surgeons stepped into complex closures for Mohs and reconstructive surgeries, and dermatologists leaned into telemedicine and even provided cosmetic consults over video conferencing.” On the technology solutions front, and as highlighted in the International Dermoscopy Society survey, nearly 20 percent of dermatologists utilized telehealth solutions for the first time.1 NextPatient, a technology firm that partners with dermatology and aesthetic practices to allow patients to book online, witnessed an accelerated adoption in online scheduling technology. “Out of necessity, the pandemic drove patients to begin evaluating their health care provider under consumer-like terms, including whether a provider’s scheduling availability is online,” says Kyle Morham, co-founder of NextPatient. “As a result of this change in patient behavior, we’ve seen an undeniable shift in practices’ buying attitude and adoption of online scheduling.” A third example of a technology-enabled provider is MedShift, which provides equipment, monitoring, and data analytics solutions to dermatology and aesthetic providers. “Practices and device manufacturers—both unable to service patients and providers in person—investigated and purchased solutions to continue business in a technology forward, remote-oriented manner,” states Brian Phillips, Chief Executive Officer of MedShift. “During and following the period of COVID-forced downtime, MedShift’s eCommerce and Payment Facilitation platform demand surged 740 percent, which enabled practices to sell vital products online to patients, and to allow manufacturers the ability to sell products to practices without in-person sales team interaction,” he adds. Today, the performance of many dermatology and aesthetic practices suggests the impact of the pandemic is shifting, and providers are seeing evidence of more predictable performance. Patient visits have increased substantially, which reinforces that a visit to the dermatologist remains a critical healthcare expenditure. Many physician groups continue their use of creative technologies and solutions to service patients and enhance margins. It is evident the value of these segments is strong and very well positioned for the future. Dermatology and Aesthetics Mergers and Acquisitions Markets: Continued Momentum In spite of the global pandemic, consolidation and investment in the dermatology and aesthetic markets have remained progressively solid. This acquisition and investment activity over the past decade has largely been driven by financial sponsors, which include private equity groups and family offices. While COVID-19 may have created a moment of pause for these investors, their optimism for these segments and their growth opportunities was not broken. These sophisticated capital sources have found the dermatology and aesthetics markets to be a safe haven to place money into, including in a time of uncertainty. In spring 2020, the dermatology M&A market experienced a “reflection moment” for buyers. This occurred as buyers had to assess the impact of the shutdowns on the state of potential dermatology investment candidates and their respective financials. With the uncertainty of the pandemic still active in summer 2020, the ability of most practice buyers to value, underwrite, and close transactions remained somewhat unsettled. However, in parallel with practices quickly learning how to operate in this new normal and the reopening of health care facilities with increasing patient visit counts, the financial performance of many were regaining their footing by fall 2020. As a result, the ability of buyers to close on transactions was revitalized. “Our team, backed by Abacus Investments and Citibank, was deep into diligence on our first tranche of partnerships as COVID peaked. It was amazing to watch these physician groups adjust, and it was clear that the dermatology and aesthetic sectors were illustrating that resilience that inspires investors,” says Mr. Rodgers. “Skin and Aesthetic Centers closed on three partnerships between December of 2020 and May of 2021: Skin Care Doctors, Minneapolis; Skin MD, Chicago; and Juva Skin and Laser Center in New York City. Not only have these practices bounced back, but all are tracking to exceed pre-COVID revenues.” With 2021 now over the halfway mark, and with many practices either back to normal performance or within striking distance of normal, there is continued M&A and investment momentum in the dermatology and aesthetics markets. A number of high-profile dermatology transactions closed from mid-2020 through Summer of 2021, proving the continued lure of capital to these segments (see Figure 2). Examples include Pine Tree Equity’s investment in Suncoast Skin Solutions, ADCS’ acquisition of Dermatology Associates of Montgomery, and the expected sale of Forefront Dermatology, one the largest national dermatology and aesthetics groups, in the near future. In short, the buyer’s market and robust valuations have returned to pre-pandemic levels, and one might argue the overall value of these segments, and the physician practice groups within it, has increased post-COVID. Technology Solutions for Physician Practice Groups Physician practice groups will continue to be the backbone of the dermatology and aesthetics markets. Buyers and financial sponsors are expanding their interest in technology-oriented firms that provide solutions to physician practice groups. The rapid adoption of new technology-oriented services to physicians include telehealth, virtual bookings, and data analytics. The investment community is responding in-kind, as daily transaction announcements in the health care technology are occurring. A recent example of capital flowing into technology-oriented companies focused on the dermatology and aesthetics market is MedShift. The company recently received strong interest in a minority equity capital raise, resulting in an oversubscribed funding round at a company valuation of $150MM. Further evidence of interest is observed by M&A trends in the telehealth segment, which witnessed an increase from 22 transactions in 2018 to a projected 81 in 2021.2 From Bundy Group’s continued health care technology-oriented firms, we see an escalation in financial sponsor interest in any firm that offers proprietary technology solutions for health care providers. The marriage of physician practice services and technology results in highly attractive value drivers and a magnet for both strategic buyers financial sponsors. We expect these health care technology firms to continue to demand great value and interest from the investment community. Figure 3: Telehealth M&A Activity (2016 – YTD 2021) The Future of the Dermatology Market Dermatology and aesthetics practices have proven they can weather a major storm and generate continued buyer and investor interest, as evidenced in the 2020/2021 rebound and resurgence. From Bundy Group client engagements in the dermatology and aesthetics industries, we have seen firsthand the continued growth of these markets and the corresponding premium valuations that can accompany independent physician practices. Not only has the value been retained by most dermatology and aesthetics independent practices, but it looks to be stronger than ever. Furthermore, technology-oriented firms servicing the health care and physician practice management markets are also demanding significant attention. Any independent physician practice group, or technology-focused health care firm, considering a sale or recapitalization, will have plenty of options and be in a great position to demand value—especially with the use of competitive pressure on buyers in a structured process. Bundy Group represented Catawba research and Dermatology Associates of Montgomery in transactions and has provided advisory services to SkinMD. Clint Bundy is a Managing Director with Bundy Group, a boutique investment bank with an extensive track record in the dermatology and health care markets. Since 1989, Bundy Group has specialized in representing practice and business owners in business sales, capital raises and acquisitions. www.bundygroup.com; clint@bundygroup.com 1. Conforti C, Lallas A, Argenziano G, Dianzani C, Di Meo N, Giuffrida R, Kittler H, Malvehy J, Marghoob AA, Soyer HP, Zalaudek I. (2021, January) Impact of the COVID-19 pandemic on dermatology practice worldwide: results of a survey promoted by the International Dermoscopy Society. Dermatol Pract Concept. 2021;11(1):e2021153. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875667/ 2. CB Insights. (2021, May 6). Telehealth cos are seeing a wave of consolidation. Here’s what that means for the future of virtual care. CB Insights Research. https://www.cbinsights.com/research/telehealth-healthcare-mergers-acquisitions-trends-analysis/.

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